Endovascular management of vein of Galen aneurysmal malformations: case series and review of the literature

Mohammed A. El-Din Habiba, Department of Neurosurgery and Neuroendovascular Intervention, Faculty of Medicine, Ain Shams University
Sameh M. Saleh, Department of Neurosurgery and Neuroendovascular Intervention, Matareya Teaching Hospital, Cairo, EgyptFollow

Article Type

Review

Subject Area

Neurosurgery

Abstract

Background Neonates with vein of Galen aneurysmal malformations (VGAMs) who present with heart failure have a high rate of morbidity and mortality, while those who present later in childhood have considerably better outcomes. Aim To determine the factors that have the greatest predictive value in predicting long-term results in children with VGAM. Patients and methods Between June 2015 and June 2020, 15 patients (seven infants, eight children) were diagnosed with symptomatic VGAMs, four of whom were suffering from intractable high-output heart failure and received initial endovascular treatment. All of them were treated by endovascular procedures. Staged transarterial route was the management approach with embolic agent with different concentrations. Results In the four patients, immediate outcomes included management of heart failure and normal neurological performance. On follow-up examination, 11 (73.33%) children had no evidence of neurologic abnormality or heart failure, four (26.66%) infants had mild developmental delays, and two of them improved with time. On digital-subtraction angiography follow-up, twelve had no additional shunting, two had limited flow, and one was awaiting follow-up imaging. Conclusion Even in the most high-risk neonates and children with VGAMs and heart failure, endovascular therapy combined with current neuroanesthetics and neurointensive care can provide good outcomes.

Keywords

cardiac failure, embolization, endovascular management, vein of Galen aneurysmal malformations

Recommended Citation

Habiba, Mohammed A. El-Din and Saleh, Sameh M. (2023) "Endovascular management of vein of Galen aneurysmal malformations: case series and review of the literature," Journal of Medicine in Scientific Research: Vol. 6: Iss. 2, Article 9.
DOI: https://doi.org/10.59299/2537-0928.1007